After Ankle Fracture Surgery (ORIF): First Two Weeks

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

The early exercises Dr. Kelly gives his patients for the first weeks after surgery, until physical therapy takes over.

Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team’s directions. In an emergency, call 911.

Precautions — read first

NO weight on the operated leg for 6 weeks — use your crutches, knee scooter, or walker. You will be in the surgical splint until Dr. Kelly sees you at 10-14 days and fits your boot. Keep the splint dry and do not remove it. Elevate the leg above heart level as much as possible — swelling control is the main job of these two weeks.

Toe Wiggles 10-15 times, every hour while awake

With the splint on, wiggle your toes through their comfortable motion to help circulation and swelling.

Quad Sets 10-15 times. 2-3 sets, 2-3 times a day

Lying with the operated leg straight, tighten the muscles on the front of your thigh. Hold 5 seconds. Relax.

Straight Leg Raise (splint on) 10-15 times. 2 sets, 2-3 times a day

Lying on your back with the other knee bent, tighten the thigh and lift the whole leg, splint and all, about one foot off the bed. Lower slowly.

Side-Lying Hip Abduction (splint on) 10-15 times. 2 sets, 2-3 times a day

Lying on your non-operated side, lift the operated leg toward the ceiling with the knee straight. Lower slowly.

Seated Knee Bends 10-15 times, 2-3 times a day

Sitting at the edge of a bed or chair, gently bend and straighten the knee of the operated leg. The splint stays on; the knee is free to move.

Later in Recovery — What Comes Next (ONLY when Dr. Kelly clears you, after your boot fitting)

These are NOT for the splint phase. Once you are in the CAM boot (10-14 days) and cleared, gentle ankle motion begins — still with no weight on the leg until 6 weeks.

Ankle Range of Motion — All Planes As tolerated, per Dr. Kelly's instruction

Gently bend the ankle up and down, in and out, and 'write the alphabet' in the air with your big toe.

Seated Towel Stretch (calf and hamstring) Per your therapist's instruction

With the leg straight, loop a towel around the ball of your foot and gently pull until a light stretch is felt.

Scar Care 2-3 minutes, daily

Once the incisions are fully healed and Dr. Kelly clears you, massage the scars with a fingertip in small circles.

When to call

Call Dr. Kelly’s office at (509) 460-5588 for fever over 101°F, increasing redness or drainage at incisions, pain that is worsening instead of improving, or new numbness or tingling. For chest pain or trouble breathing, call 911.

Questions about your recovery?

Dr. Kelly sees patients at Tri-City Orthopedics in Kennewick.

Request an Appointment